Despite widespread concern about obesity and related health risks in persons with spinal cord injury (SCI), limited weight loss interventional research has been conducted; we know little about the health benefits of weight loss or the potential adverse effects on compromising lean body mass and nutritional status, which could negatively impact these individuals' already-elevated risk of various medical complications. To address the needs and make obesity treatment more accessible, the PIs propose a pilot study of a randomized controlled design to assess the feasibility and initial effectiveness of a structured 12-week home-based weight loss program in 28 men and women with chronic SCI who are overweight or obese. Participants will be randomly assigned to one of two groups: 1) twelve weekly video and telephone intervention covering nutrition (emphasis on low energy-dense foods), exercise, and behavior modification, based on the materials developed in previous projects, and 2) usual care (one-time dietary counseling). Primary outcome measure of body weight and secondary outcomes, including body composition measured by dual energy x-ray absorptiometry and waist and neck circumference, will be examined at baseline and immediately after intervention. The PIs hypothesize that a significant weight loss will be demonstrated after the intervention without compromising lean body mass, bone density, or overall health. Process measures of attendance, satisfaction, adherence (dietary intake on food records and physical activity recall), and adverse event will also be collected throughout the study period to assess the feasibility of this intervention program. The proposed study will provide a foundation for a future large-scale trial and have a potential to enhance the knowledge of obesity treatment using alternative methods in persons with SCI. Relevance to Public Health: If shown to be effective, through an affordable and accessible home-based weight loss program, individuals with SCI worldwide can benefit with a healthier lifestyle, prevention of obesity-related diseases, and improvement in independent functioning and social participation. [unreadable] [unreadable] [unreadable]